Deep brain stimulation (DBS) is a surgical treatment involving the implantation of a medical device that sends electrical current pulses to specific regions of the brain. DBS in select brain regions has provided various therapeutic benefits for otherwise treatment-resistant movement and affective disorders such as chronic pain, Parkinson's disease, tremor, dystonia, and the like. DBS directly changes brain activity in a controlled manner. DBS effects can be reversible, unlike changes affected by lesioning techniques.
Most DBS systems include three component parts: an implanted pulse generator (IPG), a lead, and an extension. The IPG can use a battery-powered neurostimulator encased in a titanium housing that sends electrical current pulses to the brain in order to interfere with or otherwise modify neural activity at a target site. The lead can be a coiled insulated wire with four platinum iridium electrodes placed in the brain. The lead can be connected to the IPG by the extension, an insulated wire that runs from the head, down the side of the neck, behind the ear to the IPG. The IPG can be placed subcutaneously below the clavicle or in some cases, the abdomen.
While DBS can be helpful for some patients, DBS also has the potential for serious side effects. Reports in the literature describe the possibility of apathy, hallucinations, compulsive gambling, hypersexuality, cognitive dysfunction, and depression. Such side effects may be related to the incorrect placement and calibration of the stimulator. Because the brain can shift slightly during surgery, there is the possibility that the electrodes can become displaced or dislodged. The misplacement of the lead (e.g., electrode) may cause more profound complications such as personality changes, potentially requiring electrode repositioning.